Quality of survival following direct surgery for anterior communicating artery aneurysms.

The authors describe a series of 32 patients with ruptured aneurysms of the anterior communicating artery who were admitted during a 3-year period. In 28, the aneurysms were treated by direct surgery with no deaths; 26 of these patients were studied psychometrically from 4 to 33 months after operation. There was no evidence of postoperative intellectual impairment; however, there were personality changes associated with loss of interest, initiative, and energy. Analysis of the different factors involved suggests to the authors that the outcome of surgery depends mainly on preoperative clinical condition which, in turn, reflects the severity of the hemorrhage.